Supreme Court to Decide ERISA Conflict-of-Interest Issue
Posted on January 25, 2008 by Jenni Edwards
As many ERISA attorneys will tell you, the Sixth Circuit has a rather unique way of reviewing a long-term disability plan’s claims administrator denial of benefits when the participant alleges that the administrator had a conflict of interest that may have influenced its benefits determination. Now, the Supreme Court will decide whether the standard of review adopted by the Sixth Circuit is appropriate. On January 18, 2008, the Supreme Court agreed to hear arguments in Metlife, et al. v. Glenn,U.S., No. 06-923. In deciding the case, the Court will answer the following question: “If an administrator who both determines and pays claims under an ERISA plan is deemed to be operating under a conflict of interest, how should that conflict be taken into account on judicial review of a discretionary benefit determination?” Continue Reading…
Ordinance Requiring Private Employers to Pay Health Care Costs Allowed to Go Into Effect
Posted on January 25, 2008 by Kathy Krisher
A Ninth Circuit panel recently announced that it would stay a district court order and allow a San Francisco ordinance that requires private employers to provide health care coverage to their employees to go into effect. Golden Gate Restaurant v. City and County of San Francisco, No. 07-17370, 2008 U.S. App. LEXIS 364 (9th Cir. January 9, 2008).
The San Francisco Health Care Security Ordinance (the “ordinance”) requires private employers to pay a health care expenditure of up to $1.76 per hour per employee (depending on the number of employees). Any amount paid by an employer to employees or third parties on behalf of employees for the purposes of providing health care services for covered employees or reimbursing the cost of such services for covered employees constitutes an expenditure under the ordinance. Continue Reading…